Like this:

“Twenty years from now you will be more disappointed by the things that you didn’t do
than by the ones you did do.
So throw off the bowlines. Sail away from the safe harbor. Catch the trade winds in your sails.Explore. Dream. Discover.”

On World AIDS Day, more than 30 years after the first cases of this tragic illness were reported, we join the global community once more in standing with the millions of people who live with HIV/AIDS worldwide. We also recommit to preventing the spread of this disease, fighting the stigma associated with infection, and ending this pandemic once and for all.

In 2010, my Administration released the National HIV/AIDS Strategy, our Nation’s first comprehensive plan to fight the domestic epidemic. The Strategy aims to reduce new infections, increase access to care, reduce health disparities, and achieve a more coordinated national response to HIV/AIDS here in the United States. To meet these goals, we are advancing HIV/AIDS education; connecting stakeholders throughout the public, private, and non-profit sectors; and investing in promising research that can improve clinical outcomes and reduce the risk of transmission. Moving forward, we must continue to focus on populations with the highest HIV disparities — including gay men, and African American and Latino communities — and scale up effective, evidence-based interventions to prevent and treat HIV. We are also implementing the Affordable Care Act, which has expanded access to HIV testing and will ensure that all Americans, including those living with HIV/AIDS, have access to health insurance beginning in 2014.

These actions are bringing us closer to an AIDS-free generation at home and abroad — a goal that, while ambitious, is within sight. Through the President’s Emergency Plan for AIDS Relief (PEPFAR), we are on track to meet the HIV prevention and treatment targets I set last year. We are working with partners at home and abroad to reduce new infections in adults, help people with HIV/AIDS live longer, prevent mother-to-child transmission, and support the global effort to eliminate new infections in children by 2015. And thanks to bipartisan action to lift the entry ban on persons living with HIV, we were proud to welcome leaders from around the world to the 19th International AIDS Conference in Washington, D.C.

Creating an AIDS-free generation is a shared responsibility. It requires commitment from partner countries, coupled with support from donors, civil society, people living with HIV, faith-based organizations, the private sector, foundations, and multilateral institutions. We stand at a tipping point in the fight against HIV/AIDS, and working together, we can realize our historic opportunity to bring that fight to an end.

Today, we reflect on the strides we have taken toward overcoming HIV/AIDS, honor those who have made our progress possible, and keep in our thoughts all those who have known the devastating consequences of this illness. The road toward an AIDS-free generation is long — but as we mark this important observance, let us also remember that if we move forward every day with the same passion, persistence, and drive that has brought us this far, we can reach our goal. We can beat this disease. On World AIDS Day, in memory of those no longer with us and in solidarity with all who carry on the fight, let us pledge to make that vision a reality.

NOW, THEREFORE, I, BARACK OBAMA, President of the United States of America, by virtue of the authority vested in me by the Constitution and the laws of the United States do hereby proclaim December 1, 2012, as World AIDS Day. I urge the Governors of the States and the Commonwealth of Puerto Rico, officials of the other territories subject to the jurisdiction of the United States, and the American people to join me in appropriate activities to remember those who have lost their lives to AIDS and to provide support and comfort to those living with this disease.

IN WITNESS WHEREOF, I have hereunto set my hand this twenty-ninth day of November, in the year of our Lord two thousand twelve, and of the Independence of the United States of America the two hundred and thirty-seventh.

Global study finds homophobia, comfort with service provider, and community engagement make significant impact on access to condoms, lubricant, HIV testing, and HIV treatment

A large-scale study of gay men and other men who have sex with men (MSM), conducted by the Global Forum on MSM & HIV (MSMGF), indicates that only one third of MSM can easily access condoms, lubricant, HIV testing, and HIV treatment. Combining a multi-lingual online survey and focus group discussions, the study suggests that structural barriers like homophobia play a significant role in blocking access to HIV services for MSM, while greater comfort with service providers and community engagement are associated with higher levels of service access.

The MSMGF’s study aimed to identify barriers and facilitators that affect access to HIV services for MSM. The online survey conducted this summer included 5779 men from 165 countries. In addition, the MSMGF collaborated with African Men for Sexual Health and Rights (AMSHeR) to conduct focus group discussions with a total of 71 MSM across five cities in South Africa, Kenya, and Nigeria.

Of men who participated in the online survey, only 35% reported that condoms were easily accessible, 21% reported easy access to lubricant, 36% reported easy access to HIV testing, and 42% reported easy access to HIV treatment. Levels of access differed across low-, lower-middle-, upper-middle- and high-income countries, with reduced access to services more commonly reported in lower-income countries.

Percent of MSM reporting that condoms, lubricant, HIV testing, and HIV treatment
are easily accessible(organized by country income level using World Bank country income classifications)

“Such poor levels of access at the global level are unacceptable,” said Dr. George Ayala, Executive Director of the MSMGF. “The differences in access by country income level are especially important to note as the Global Fund moves into a new funding model where countries are grouped into bands by income level. Even in upper-middle-income countries, MSM still have extremely low access to services. Without targeted funding to MSM and other key populations, the new funding model may continue to deteriorate levels of access for the groups most affected by HIV.”

The MSMGF research team also conducted analyses to identify barriers (factors associated with lower access) and facilitators (factors associated with higher access) that impact the ability of MSM to obtain condoms, lubricant, HIV testing, and HIV treatment.

Adjusting for country income, greater access to condoms, lubricants and HIV testing were associated with less homophobia, greater comfort with health providers, and more community engagement. Among participants living with HIV, higher access to HIV treatment was associated with less homophobia and greater comfort with service providers. Greater access to lubricants and greater access to HIV testing were also associated with less outness (the degree to which others know of one’s sexual orientation) and fewer negative consequences as a result of being out, respectively.

“As we collectively forge ahead into the new territory of treatment-based prevention, it is clear that many of the old challenges remain,” said Noah Metheny, Director of Policy at the MSMGF. “Addressing structural barriers remains essential to realizing the potential of HIV interventions for MSM, and it becomes more important with each new prevention and treatment option that is made available. Investments in the development of new interventions must be accompanied by efforts to increase access.”

The quantitative data from the online survey was supplemented with qualitative data from focus group discussions, helping to place barriers and facilitators in the broader context of the sexual health and lived experiences of MSM. Focus group discussion participants identified barriers and facilitators that were highly consistent with those found in the online survey, and many participants explained the ways that structural barriers at the policy, cultural, and institutional levels cascade down through the community and individual levels to block access to services for MSM.

Focus group discussion participants described how structural barriers like stigma, discrimination, and criminalization force MSM to hide their sexual behavior from health care providers, employers, landlords, teachers, and family members in order to protect themselves and maintain a minimum livelihood. The inability of MSM to reveal their sexual behavior to health care providers was linked to misdiagnosis, delayed diagnosis, and delayed treatment, leading to poor health prognosis and higher risk of transmitting HIV and other sexually transmitted infections to partners.

Conversely, focus group discussion participants explained that the negative consequences of structural barriers were moderated by the existence of safe spaces to meet other MSM, safe spaces to receive services, access to competent mental health care, and access to comprehensive health care. Participants described MSM-led community based organizations as safe spaces where they could celebrate their true selves, receive respectful and knowledgeable health care, and in some cases receive mental health services.

“The study’s findings underscore the urgent need to improve access to essential HIV services for gay men and other MSM worldwide,” said Dr. Ayala. “Interventions must both disrupt the negative effects of barriers and bolster the protective effects of facilitators. Study participants clearly indicated that community engagement and community-based organizations are central to moderating barriers and facilitating service access. Successfully addressing HIV among MSM will require a real effort to address structural barriers, and the findings from this study suggest that investing in MSM-led community-based organizations may be the best way to do that.”

Agreed. MSM-led community-based organizations must continue to work tirelessly to eliminate fear, shame, stigma and ignorance. They are all still very much with us.

In one of the longest and most emotional meetings in the St. Louis County Council’s history, an ordinance was narrowly passed Tuesday night that adds gender identity and sexual orientation to the county’s anti-discrimination regulations and hate crimes law.

An overflow crowd of more than 250 people spilled out of the council chambers in Clayton; 92 of them signed up to address the council, and most took advantage of that opportunity in a public comments segment that lasted more than two hours.

And as could be expected on an issue that involved religion and civil rights, most of them spoke fervently.

The ordinance adds protections for people in employment, housing and public accommodations in unincorporated areas, regardless of their sexual orientation. It also expands protections on the basis of gender and disability.

Harvey Milk of San Francisco By Brother Robert Lentz, OFM. Copyright 1987Courtesy of www.trinitystores.com (800.699.4482)

Pioneering gay rights activist Harvey Milk (1930-1978) was assassinated on Nov. 27, 1978 (34 years ago today). Milk is the first and most famous openly gay male elected official in California, and perhaps the world. He became the public face of the LGBT rights movement, and his reputation has continued to grow since his death. He has been called a martyr for GLBT rights.

“If a bullet should enter my brain, let that bullet destroy every closet door in the country,” Milk said. Two bullets did enter his brain, and his vision of GLBT people living openly is also coming true.

Milk has received many honors for his visionary courage and commitment to equality. He is the only openly gay person in the United States to have an official state holiday in his name. Harvey Milk Day is celebrated in California on Milk’s birthday, May 22. The bill establishing Harvey Milk Day was signed in to law in fall 2009, and the holiday was celebrated for the first time this year. State employees still have to work on Harvey Milk Day, but California public schools are encouraged to teach suitable commemorative lessons about the gay rights activist.

In 2009 Milk was posthumously awarded the Presidential Medal of Freedom and inducted into the California Hall of Fame. He was included in the Time “100 Heroes and Icons of the 20th Century” for being “a symbol of what gays can accomplish and the dangers they face in doing so.”

Milk was elected to the San Francisco Board of Supervisors in 1977 after three unsuccessful efforts to run for office. He served only 11 months before he was killed, but in that short time he was responsible for passing a tough gay-rights law.

Haunted by the sense that he would be killed for political reasons, Milk recorded tapes to be played in the event of his assassination. His message, recorded nine days before his death, included this powerful statement:

“I ask for the movement to continue, for the movement to grow, because last week I got a phone call from Altoona, Pennsylvania, and my election gave somebody else, one more person, hope. And after all, that’s what this is all about. It’s not about personal gain, not about ego, not about power — it’s about giving those young people out there in the Altoona, Pennsylvanias, hope. You gotta give them hope.”

Shots fired by conservative fellow supervisor Dan White cut Milk’s life short. More than 30 years later, the hope and the movement for GLBT rights are more alive than ever.

The Harvey Milk icon painted by Robert Lentz (pictured above) was hailed as a “national gay treasure” by gay author/activist Toby Johnson. Milk holds a candle and wears an armband with a pink triangle, the Nazi symbol for gay men, expressing solidarity with all who were tortured or killed because of their sexuality.

It is one of 10 Lentz icons that sparked a major controversy in 2005. Critics accused Lentz of glorifying sin and creating propaganda for a progressive sociopolitical agenda, and he temporarily gave away the copyright for the controversial images to his distributor, Trinity Stores. All 10 are now displayed there as a collection titled “Images That Challenge.”
_________
This post is part of the GLBT Saints series at the Jesus in Love Blog. Saints and holy people of special interest to gay, lesbian, bisexual and transgender (GLBT) people and our allies are covered on appropriate dates throughout the year.

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D Gregory Smith is a gay, HIV+ native Montanan; a Rome-educated Episcopal priest and a licensed mental health counselor. He is a member of the board of directors of Pride Foundation and Interchange.
He is also a teacher, health educator, firm and gentle activist, poet, theologian, spiritual adventurer, husband, interviewer, geek, opinionated and witty social-justice-oriented optimist who loves to write- and he does (when he can find time) here and at Bilerico.com. He is also a contributor to several other blogs and sites, including the newsmagazine LGBTQ Nation.

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